Feasibility of endoscopic hand suturing on rectal anastomoses in ex vivo porcine models

Abstract

Prevention of postoperative anastomotic leakage in rectal surgery is still required. This study investigated the feasibility of endoscopic hand suturing (EHS) on rectal anastomosis ex vivo. By using isolated porcine colon, we prepared ten anastomoses 6–10 cm from the virtual anus. Then, we sutured anastomoses intraluminally by EHS, which involved a continuous suturing method in 5 cases and a nodule suturing method with extra corporeal ligation in 5 cases. Completeness of suturing, number of stitches, procedure time and presence of stenosis were investigated. Furthermore, the degree of stenosis was compared between the two suturing methods. In all cases, EHS were successfully completed. The median number of stitches and procedure time was 8 and 5.8 min, respectively. Stenosis was created in all continuous suturing cases whereas none was seen in nodule suturing cases. The shortening rate was significantly greater in the continuous suturing method than in the nodule suturing method. Intraluminal reinforcement of rectal anastomosis by EHS using nodule suturing with extra corporeal ligation is feasible without stenosis, which may be helpful as a countermeasure against possible postoperative anastomotic leakage in rectal surgery.

Effect of continuous nursing on wound infection and quality of life in patients with cancer‐related stoma: A meta‐analysis

“…Post-enterostomy changes the normal physiological bowel movements of the patients, resulting in a lack of bowel control, significantly impacting the psychological, physical, and social interactions of the patient and seriously affecting the quality of life of the patient. 29 Li et al showed that the implementation of a continuous nursing model could facilitate comprehensive care for patients with a stoma, including stoma care training, health education, and guidance on daily living, which can enhance self-efficacy and adaptation of the patients to the stoma, thus improving their quality of life, which is consistent with the findings of this study. 13 Numerous studies have shown that effective health interventions can ameliorate the negative emotions of patients that underwent colostomy, reduce the incidence of postoperative complications, and improve their quality of life.…”

“…This study showed that continuous nursing improved the quality of life of the patients. Post‐enterostomy changes the normal physiological bowel movements of the patients, resulting in a lack of bowel control, significantly impacting the psychological, physical, and social interactions of the patient and seriously affecting the quality of life of the patient 29 . Li et al showed that the implementation of a continuous nursing model could facilitate comprehensive care for patients with a stoma, including stoma care training, health education, and guidance on daily living, which can enhance self‐efficacy and adaptation of the patients to the stoma, thus improving their quality of life, which is consistent with the findings of this study 13 .…”

Endoscopic full‐thickness resection with endoscopic hand suturing for rectal neoplasm involved in an anastomotic line

“…2). We sutured the muscular layers at the full‐thickness defect with EHS using the nodule‐suturing method with extracorporeal ligation 3 . The time elapsed during resection and EHS was 92 min and 32 min in four stitches, respectively.…”